Individual
MR. GREGORY WORTHING MASIKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PT
Contact information
Practice address
331 WILMINGTON PIKE, SUITE 1, GLEN MILLS, PA 19342-2277
(610) 558-5866
Mailing address
420 BAINBRIDGE ST, PHILADELPHIA, PA 19147-1568
(215) 629-1270
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT016673
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1650476
BC/BS HMO
PA
01
—
2327928000
BC/BS PPO
PA
01
—
7158567
AETNA
PA
Enumeration date
07/12/2005
Last updated
04/16/2008
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